Paramedic Management of Non-Traumatic Back Pain in a Large Australian Ambulance Service: A Retrospective Study.

IF 2.1 4区 医学 Q2 EMERGENCY MEDICINE
Prehospital and Disaster Medicine Pub Date : 2025-04-01 Epub Date: 2025-04-07 DOI:10.1017/S1049023X25000251
Simon P Vella, Chathurani Sigera, Jason C Bendall, Paul Simpson, Christina Abdel-Shaheed, Michael S Swain, Chris G Maher, Gustavo C Machado
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引用次数: 0

Abstract

Introduction: Non-traumatic back pain commonly leads people to seek health care from paramedics via triple-zero (emergency phone number in Australia), yet the management approaches by providers of ambulance services remain unclear.

Study objectives: This study aims to investigate paramedic management of non-traumatic back pain in New South Wales (NSW), Australia, including the call characteristics, provisional diagnoses, and the clinical care being delivered by paramedics.

Methods: This study is a retrospective analysis of NSW Ambulance computer-aided dispatch and electronic medical records from January 1, 2017 through December 31, 2022. Adults who sought ambulance service with a chief complaint of back pain, were triaged as non-traumatic back pain, and subsequently received treatment by paramedics were included. Multivariable logistic regression models were used to explore factors associated with primary outcomes; ambulance transport, opioid use, and use of medication combinations were reported as odds ratios (ORs).

Results: There were 73,128 calls to NSW Ambulance with a chief complaint of back pain that were triaged as non-traumatic back pain. Of these, 54,444 (74.4%) were diagnosed with spinal pain, of which 52,825 (97.1%) were categorized by the paramedic as back or neck pain, 1,573 (2.9%) as lumbar radicular pain, and 46 (0.1%) as serious spinal pathology. Eight out of ten patients with spinal pain were transported to emergency departments. The medicine most administered by a paramedic was an opioid (37.4% of patients with spinal pain). Older patients (OR = 1.36; 95% CI, 1.30 to 1.44) were more likely to be transported to an emergency department. Patients with moderate (OR = 4.39; 95% CI, 4.00 to 4.84) and severe pain (OR = 18.90; 95% CI, 17.18 to 20.79) were more likely to be administered an opioid.

Conclusions: Paramedic management of non-traumatic back pain in NSW typically results in the administration of an opioid and transport to an emergency department.

非创伤性背部疼痛的护理人员管理在一个大型澳大利亚救护车服务:回顾性研究。
简介:非创伤性背痛通常导致人们通过三零(澳大利亚的紧急电话号码)向护理人员寻求医疗保健,但救护车服务提供者的管理方法仍不清楚。研究目的:本研究旨在调查澳大利亚新南威尔士州(NSW)非创伤性背痛的护理人员管理,包括呼叫特征,临时诊断和护理人员提供的临床护理。方法:本研究回顾性分析2017年1月1日至2022年12月31日NSW救护车计算机辅助调度和电子病历。以背部疼痛为主诉寻求救护车服务的成年人被分类为非创伤性背部疼痛,随后接受护理人员的治疗。采用多变量logistic回归模型探讨与主要结局相关的因素;救护车运输、阿片类药物使用和药物联合使用以优势比(ORs)报告。结果:有73,128个呼叫新南威尔士州救护车与背部疼痛的主诉被分类为非创伤性背部疼痛。其中54,444例(74.4%)被诊断为脊柱疼痛,其中52,825例(97.1%)被护理人员分类为背部或颈部疼痛,1,573例(2.9%)为腰椎神经根性疼痛,46例(0.1%)为严重脊柱病理。10名脊椎疼痛患者中有8人被送往急诊室。护理人员使用最多的药物是阿片类药物(37.4%的脊柱疼痛患者)。老年患者(OR = 1.36;95% CI(1.30 ~ 1.44)更有可能被送往急诊室。中度患者(OR = 4.39;95% CI, 4.00 ~ 4.84)和剧烈疼痛(OR = 18.90;95% CI, 17.18 ~ 20.79)更有可能使用阿片类药物。结论:新南威尔士州非创伤性背痛的护理人员管理通常导致阿片类药物的管理和转运到急诊室。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Prehospital and Disaster Medicine
Prehospital and Disaster Medicine Medicine-Emergency Medicine
CiteScore
3.10
自引率
13.60%
发文量
279
期刊介绍: Prehospital and Disaster Medicine (PDM) is an official publication of the World Association for Disaster and Emergency Medicine. Currently in its 25th volume, Prehospital and Disaster Medicine is one of the leading scientific journals focusing on prehospital and disaster health. It is the only peer-reviewed international journal in its field, published bi-monthly, providing a readable, usable worldwide source of research and analysis. PDM is currently distributed in more than 55 countries. Its readership includes physicians, professors, EMTs and paramedics, nurses, emergency managers, disaster planners, hospital administrators, sociologists, and psychologists.
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